CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 43266 RVU and Medicare Payment (2026)
Egd endoscopic stent place — 3.82 work RVU, about $192.39 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.82
- PE RVU (non-facility)
- 1.46
- PE RVU (facility)
- 1.46
- MP RVU
- 0.48
- Office payment
- $192.39
- Facility payment
- $192.39
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 43266 in a non-facility setting with national GPCI: (3.82 + 1.46 + 0.48) × $33.4009 ≈ $192.39. The same code in a facility setting pays about $192.39 because facility PE RVU (1.46) replaces office PE RVU.
What changes by locality
GPCI moves 43266 non-facility payment from $177.74 to $252.16 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 43266?
3.82. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 43266 in 2026?
About $192.39 non-facility ($192.39 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (3.82) and malpractice RVU stay fixed; only practice expense changes (1.46 office vs 1.46 facility). That is the entire office-vs-facility payment gap.